Senate sends Medicaid bill to hostile House

HARRISBURG, Pa. (AP) — The Pennsylvania state Senate approved legislation to require Gov. Tom Corbett to seek federal approval for an expansion of Medicaid eligibility to hundreds of thousands of Pennsylvanians, although it faces death in the more conservative House of Representatives where Republican leaders have vowed not to bring it to a floor vote.

The 40-10 vote was held Sunday night as lawmakers scrambled to finish up their spring and summer session. All 23 Democrats voted for it, as did 17 of 27 Republican senators, including Senate President Pro Tempore Joe Scarnati, R-Jefferson, and Senate Majority Leader Dominic Pileggi, R-Delaware.

It passed without floor debate.

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With lawmakers scrambling to wrap up a mountain for work for the fiscal year, the Senate's Republican majority cooperated with Democrats to insert the provision in a crucial piece of budget-related legislation in an eleventh-hour effort to force the hand of Corbett, a Republican, and hostile House Republican leaders.

Corbett has not said whether he would sign it, although Senate Republican and Democratic leaders say they negotiated the amendment with Corbett's office, and wrote certain conditions into it to make it more amenable to him, as well as Republican lawmakers who might otherwise oppose the health care law.

Asked about it Sunday night during a budget signing ceremony, Corbett stressed that his administration is working with the federal government to secure the kind of "reforms" he believes are necessary in the Medicaid program to make it cost-effective enough to join the Medicaid expansion.

"We're working to get the reforms," Corbett said. "I have to see a bill that has reforms in it."

Senate Public Health and Welfare Committee Chairman Patricia Vance, R-Cumberland, said she would not predict what Corbett would do if it reaches his desk. But she said opponents who view it as a part of President Barack Obama's 2010 health care law and dislike it because of that simply do not understand how it will benefit the state.

"I think it's almost a knee-jerk reaction," Vance said. "They don't like Obama. So this is part of Obamacare, so we hate it. That seems to be the rationale without understanding what it means for each area."

Senate Minority Leader Jay Costa, D-Allegheny, called the legislation "historic" and predicted that Corbett will sign it, if it reaches his desk. However, he said he could not predict how the Senate will react if the House strips the Medicaid expansion provision and sends it back to the Senate.

Ultimately, the governor's office would need to submit a plan that wins federal approval for the expansion. The bill requires Corbett to submit a plan by Oct. 1 in an effort to compel expanded Medicaid eligibility in Pennsylvania by July 1, 2014.

An expansion is designed to provide federally funded health care coverage to hundreds of thousands, primarily uninsured adults, beginning next year.

The Legislature's nonpartisan fiscal analysts have agreed with the conclusions of studies sponsored by health care groups that an infusion of billions of federal health care dollars would boost Pennsylvania's finances by hundreds of millions of dollars a year.

Corbett and other Republican critics of the Medicaid expansion insist they believe it will be an unsustainable cost to Pennsylvania taxpayers and worry about whether the federal government will keep its funding pledge.

The 14 conditions in the bill include employment and job search requirements, cost-sharing by enrollees and maximized use of private insurance plans instead of the traditional Medicaid plan. It also would revoke an expansion if the federal government backtracks on its pledge to pay for nearly all the cost to enroll adults up to 138 percent of the federal poverty level, or about $15,000 for one person.